Objective. To systematically evaluate and compare healthcare innovations in three geographically small nations, Ireland, Israel, and Switzerland, and to explore the factors that contribute to both innovations and diffusions of innovations.

Design. Systematic review of published articles.

Data Survey. CINAHL, ProQuest, PubMed Central, Google Scholar and Citation Lists. All articles published 2017 and earlier will be included in the search.

Results. The data analysis for this systematic review followed the PRISMA guidelines that encapsulated the basic eight steps for systematic review process. Academic search engines were used to identify studies relevant to the topic under study. The CASP checklist was used to evaluate the quality of the study, along with determining whether the study met the eligibility criteria for this systematic review. Eighty-nine full text sources were included in the final assessment, and 57 of these were excluded from the final review because, while some appeared in scholarly journals, these were either webpages, conference papers, commentaries, interviews, or news related. The 32 remaining full text articles were included in the review.

In addition to the systematic literature review, six Subject Matter Experts were interviewed. Participants’ responses showed clear perspectives on the critical success factors v necessary for healthcare innovation to thrive within a country and an organization. Their responses overlapped in answering each of the research questions. The principal areas of concern included committed leadership, collaborative cultures, cost effectiveness, planning, and futureoriented thinking. These areas were the top critical success factors for healthcare innovation. However, these also represented concerns about and barriers to it. The absence of these factors potentially stalled innovation in a country. This stall occurred if that country lacked openness to new ideas or was extremely risk adverse. These various factors required further study to understand the overall effect on healthcare innovation in different contexts.

Conclusion. Small nations that innovate in healthcare benefit the most from government subsidies of research and development. Additionally, benefits accrue exponentially with strong global partnerships. The development of national and international partnerships occurred when existing internal information was shared at the beginning of the innovation process. Connecting healthcare stakeholders is necessary for improving innovation experts. Developing new methods of measuring innovation will significantly aid in understanding the influence of adaption and diffusion of innovations in healthcare systems. The implications of this study suggest that our understanding of innovation and innovation diffusions have the potential to lead to adaptations. However, we don’t yet fully understand the most efficacious way to measure innovation and its impact on society.

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